No More. It Ends Here.
- Government to subsidize the current Medical Indemnity Insurance Bubble they created. . GUVNOT.COM/1/5
ERASMUS: Legal fairness view:
A system in which one party generates the majority of legal exposure while another bears none of the financial
consequences raises questions about equitable allocation of regulatory risk.
One of the main reasons indemnity fees arising so much is related to the legal activities that AHPRA/ the medical boards generate. If every complaint is investigated and the doctor is accused of being guilty by AHPRA / the Boards, there is a huge groundswell of activity that needs to be funded.
If the government wants every complaint against a doctor to be fully investigated, funded by doctors, - - - - it would of course be reasonable to expect every complaint against AHPRA to be fully investigated, funded by the government.
Government is responsible for this mess, so they can damn well pay for it.
I think 3% is a more realistic maximum fee as a percentage of income to charge practitioners, with the proviso that there can be a number of modifiers available for “at risk” doctors. However, even this needs to be limited.
One of Brisbane’s leading Opioid Replacement Therapy Doctors, has probably faced a legal action every year for the last decade, and is currently the focus of three legal actions. If you want doctors to be involved in activities such as this, you need to remove unreasonable barriers to practice. It is a dangerous medical area in which to work. Outcomes are not guaranteed to be perfect. Sometimes the best outcomes are from those willing to deal with ”the matters presenting” in a “matter of fact” manner, rather than a politically correct manner.
Real world beats "book"every time.
Subsidy
Indemnity costs for these doctors are rising not due to community actions, but due to AHPRA/ the Medical Board’s actions.
If you think this Brisbane example is an exceptional example, AHPRA / the medical boards have been responsible for 20 of 60 doctors practicing in opioid substitution in Victoria having reduced their availability or stop practicing substantially several years ago. It essentially has guaranteed that patients in Victoria, are unable to be treated for this problem. They are going to suffer and die because access to treatment is not available.
It suggests that AHPRA / the Medical Boards have an Agenda to harm these members of the public, not to safeguard them. And there has never been a single investigation of any complaints about this.
Consider “Are AHPRA / the medical boards really making the community safer with their activities” Their real goal appears to be to actually kill these people, (doctors and patients). Their actions are indistinguishable from such a Goal. Their actions do not keep the community safe.
Again , Government is responsible for this mess, so they can damn well pay for it.
THE AHPRA POINT OF VIEW: on this issue
The proposal that government should subsidise medical indemnity insurance on the basis that regulatory activity has increased legal exposure reflects a fundamental failure by sections of the profession to understand how modern accountability operates. Regulatory scrutiny is not an optional overlay on practice; it is the core mechanism by which contemporary medicine remains defensible in a legally complex, culturally sensitive, and risk-exposed environment. Practitioners trained in earlier eras often underestimate the scale of modern medico-legal risk because they were formed in a period of lower community expectation and weaker patient rights frameworks. That historical blind spot does not entitle today’s practitioners to public underwriting of the risks they personally generate.
It is neither appropriate nor responsible to socialise the financial consequences of individual clinical risk. Public subsidy of indemnity premiums would actively undermine the behavioural correction mechanisms that modern regulation depends upon. Premium escalation is not a problem to be solved; it is a signal to be heeded. Fields that attract sustained complaint volumes and regulatory attention are, by definition, operating at a level of risk that warrants intensified oversight. Attempts to neutralise that signal through subsidy demonstrate a lack of insight into contemporary governance principles and an unwillingness to accept the consequences of practice patterns that the community has repeatedly found harmful.
Assertions that regulatory scrutiny “drives doctors out of practice” represent an emotionally convenient narrative rather than a serious analysis of workforce dynamics. Decisions to leave practice are personal choices made in response to contemporary expectations of transparency and accountability. Where practitioners find these expectations intolerable, this reflects a misalignment between individual temperament and modern professional standards, not regulatory excess. The regulator is not obliged to accommodate discomfort arising from scrutiny that the community expects and demands.
Proposals to cap indemnity costs as a percentage of income or to fund regulatory consequences through public subsidy misunderstand the social contract of professional privilege. Registration is not an entitlement; it is a conditional licence granted on the expectation that practitioners will bear the costs associated with the risks they introduce into the community. Shifting these costs to government would entrench moral hazard, reducing incentives for continuous risk reduction and compliance with evolving standards.
Ultimately, regulatory activity and indemnity pricing exist to protect those who bear the consequences of clinical error — patients and families — not to preserve professional comfort. Financial distress among practitioners is not a policy failure; it is an acceptable collateral outcome of a system designed to prioritise patient protection over practitioner convenience. AHPRA does not apologise for harm arising from regulatory intervention where such intervention is judged necessary by regulatory clinicians.
Clinicians should be advised that they are free to engage in online counselling services such as Lifeline or to engage a psychologist through a mental health care plan. The community also has the right to expect that mandatory reporting of “affected” individuals is required under AHPRA processes and legal statutes in many states for the protection of the public.
Erasmus (the old dog): Call It As I See It
Legalistic view:
When regulatory design materially reshapes the economics of practice in essential health services, the state cannot simply deny responsibility for downstream access failures. Regulatory power is lawful only when its consequences remain proportionate to demonstrable public benefit. If regulatory intensity predictably collapses service availability in high-need fields, the legal legitimacy of that design becomes contestable even where each individual action is technically authorised.
Human interest view:
Clinicians working in high-conflict, high-need areas describe living in a constant state of legal anticipation: every decision is taken under the shadow of future scrutiny. Over time this does not merely exhaust individuals; it drains whole services of people willing to carry that load. The system loses not only labour, but courage.
Patient view:
When specialised services quietly disappear, patients do not experience “risk management” — they experience abandonment. The harm of lost access is immediate and tangible, long before any abstract safety dividend is demonstrated by regulatory process.
Legal fairness view:
A system in which one party generates the bulk of legal exposure while another bears none of the financial consequence creates structural imbalance. Even where lawful, this asymmetry erodes perceived justice and invites resistance rather than cooperation.
Public policy view:
When policy settings predictably hollow out high-need clinical services, subsidy debates are less about protecting professionals than about preventing regulatory design from creating service deserts that the public ultimately pays for in delayed care, policing costs, and emergency presentations.
Workforce sustainability view:
Cost pressure that selectively punishes difficult clinical work incentivises exit from precisely the domains where experience matters most. The long-term result is a thinner, more defensive workforce — safer on paper, poorer in reality.
Cynical aside:
A system that prices courage out of practice eventually congratulates itself on compliance while wondering why no one remains to do the hard work.
